Anne: Hi everybody. It's Anne Duffy and welcome to Dental Entrepreneur, the Future of Dentistry podcast. I'm so glad that you're here today. So happy. I have a new guest we have never met before I don't really know anything about. His company and he is here because he is the future of dentistry and I can't wait to share this information with all of you that are listening today.
It's gonna be very yummy I want you to help me welcome Nathan Monty. Hi Nathan.
Nathan: Hi, Anne. How are you?
Anne: How are you? I'm just doing great.
Nathan: It's another wonderful day, right? Living the dream.
Anne: Living the dream. At Chicago Midwinter we are.
It's like six degrees. Yeah.
Nathan: when the wind comes off that lake less than six
Anne: It's less than six degrees. And especially when your Uber drops you off at the wrong entrance at the McCormick Center, and you have to walk three blocks to the correct entrance in high heels. That was fun yesterday. So today I'm in, I've got some nice little kicks on having the best day of my life and I'm really excited to meet Nathan because it's always fun to meet new people to find out what they're doing to really support the dental industry.
So, Nathan, tell me about your company and what you have to offer to the dental industry.
Nathan: Sure. So I'm the co-founder and CEO of Enamel
Pure.
I got into dentistry back in 2009, 2010. I was the founder of Convergent Dental, the inventor of Sole,
Anne: Oh yes,
Nathan: which is sold by Patterson. Right now I'm the largest common shareholder and Convergent Dental. To this day, we're still waiting for our exit.
Okay. And I left in 2017. And then in 2022, my business partner Chuck Dresser, and I started Enamel Pure. So Sole and Convergent Dental are on the, you know, repair the restorative side of dentistry. And so we pivoted over to the preventive side of
dentistry with enamel pure. we're using a CO2 laser and an imaging camera to redefined prevention as well as introduced.
Computerized diagnostics driven by AI for prevention in dentistry. We hope it completely changes the way dentistry is done as well as build going forward, So we use the laser to clean people's
Anne: teeth.
Nathan: That's number one. Number two, we use the laser to harden teeth to eliminate interoffice fluoride.
And then we have a whitening mouth guard with a little battery in it so the patient can pop it in and drive home and throw it away when they get home.
Anne: Really?
Nathan: Yeah,
that's Okay. That's pretty
Anne: cool. So then the camera is attached to the beam delivery with the laser and the laser's invisible. So while the laser's doing the cleaning, the camera's flashing to image your teeth, so you get a full 3D dental scan.
Nathan: For everybody that gets their teeth cleaned. So The key here is everybody's known that dentistry's perfect for ai. ' cause all the diagnostics, they define oral, health with what they see. The hygienists and the dentist. Look at your teeth, look at your gums, and basically what they see is, leads to their diagnostics? So imagery's perfect in ai, of course, with machine learning's perfect for the imagery section as well. The issue is it's very difficult to get anybody to sit in the chair. You do a half an hour or an hour cleaning appointment, and then, okay, can you sit in here for another 10 or 15 minutes?
And people just say, no I'm done. That's right. And it's quite surprising I was talking about laser hardening t to replace fluoride and Mary Joe Potter in uh, San Francisco. She's an angel investor. Out of the Sandhill Angel group, she said I, I have a question.
Can you just clean my teeth with a laser? Two? I just hate going for dental cleanings. So then I said well, I don't know, but we'll look at it. Mary Jo and I just so I looked it up, 160 million teeth cleanings a year by 220,000 hygienists. It adds up to be about a $16 billion out of pocket. You know, Some of it's insurance with, some of it's your pocket, but $16 billion a year spent on cleaning teeth and putting fluoride on your teeth.
It's just a staggering number. 160 million people get in that chair to have their teeth cleaned and while they're there, our idea was let's image 'em while they're in the chair. Therefore, we get the images for the first
Anne: ever.
Okay. and that's how we do it. So we, clean your teeth. It's much faster.
Nathan: It's twice as fast, 40, 50% faster than the manual methods. Completely removes the plaque down to the bear enamel. And then it also kills the bacteria. 'cause the lasers vaporizing everything. So the temperature's raised enough. So all the bacteria and viruses are killed all at the same time.
And we have a sub gingival hampe. It's a little piece of lab grown diamond. It's in shape of a little ramp, a wedge. And so you just go under the gums, a couple millimeters with that, drag it along the teeth, it's diamonds so that the teeth won't scratch it. And that way you can clean under the gums as well.
The diamond wedge is designed so that the energy bounces off the top and goes down onto the tooth, not into the gums, not into the roots. So in that way, we completely clean your teeth, kill all the bacteria and then when you're done, it takes about five minutes. It's five to six seconds per side of tooth.
Takes about 5, 6, 7 minutes to clean your teeth, and then you can go back over the teeth. It much more quickly with the laser to harden
them. they're five or 10 times harder than fluoride. The laser hardening is a fabulous technology developed at the University of California San Francisco over the last 30 years.
And so we're just implementing it. So the cleaning and the hardening and then while you do it, the camera's imaging, doing your interoral scan. So everything's all done in 10 minutes. And nobody feels anything. There's no pain, there's no sensation.
Anne: You're talking to hygienists here? I'm like, what is happening here? So wait a minute. What are you hardening? I'm sorry,
what are you
Nathan: Oh, so I'll be a little technical here. Bear with me. Right? So your your enamels made up of hydroxyapatite, but it's actually carbonated hydroxy, and I don't know if you've ever seen that phrase. So the, hydroxy appetite structure.
Has carbonate molecules embedded in it. That's naturally, it comes from a,
when you're born and you're raised and your body builds out. But we call it an impurity enables not pure hydroxyapatite. There's some other impurities in it, but carbonates, the major one.
So what the laser does is selectively removes the carbonate. To purify your enamel, and then the enamel structure so the enamel or the hydroxyapatite structure becomes more consistent, more equal. And by doing that, it's harder for the acid molecules to get in between the hydroxyapatite molecules and break those bonds.
that's how we do it. We remove the carbonate, we remove the impurity from your enamel. On the outside of the enamel, it's a very, very thin outer coating. Five times, six times thinner
Anne: than
a piece of hair.
Okay.
Nathan: It's extremely thin, but it's thorough. fluoride varnish might connect. It might, fluoro appetite.
It might. Attach it some places on your teeth, other places it doesn't because it's all dependent on attached to the chemical process in your mouth. The hydroxy appetite has to break down so the fluoro can attach to the appetite and then create fluoro appetite. So this is a phase change process where we're removing the carbonate. So it's
Anne: completely different but does it make, the enamel porous in a sense? Am I visualizing it like that?
Nathan: that's a great question and, the answer is less porous. But we're on a molecular scale here, right? You nothing you're ever gonna see, right? Yeah. It would have to be like 500 times zoomed on a microscope to see it. But what the carbonate does is it lodges itself naturally when your teeth grow in between the hydroxyapatite molecules stretching.
The two molecules away from each other, creating a little gap.
So when the laser removes the carbonate, we call it an impurity, but again, it's natural. Then the, hydroxy appetites molecules snap back a little bit towards each other and close that gap ever so
Anne: slightly. It
doesn't have to
Nathan: to be much. And ever so slightly, and that on a molecular level keeps the acid molecule from getting in between the hydroxyapatite structure. Yeah, that's how it works.
Anne: Alright, well now I'm getting it. I'm, tracking with you now. that's so interesting
though. It's
like a total game
Nathan: so fluoride's completely different. Fluoride is your hydroxy appetite has to break apart.
So you have free appetites for the fluoride to attach to, to create the fluoro appetite. So the, chemical process, the fluoride process, you have to have a varnish. don't need any varnish or anything extra for our process. And then also. mouth is full of all sorts of,
different
types of proteins and bacteria and everything that interrupts that fluoro appetite process.
So our lazing process, none of that matters. You've already cleaned your teeth, you vaporized everything off your teeth, so it's a complete. Thorough hardening over the whole surface, it's five or 10 times harder. The only downside is this extremely thin, so you
Anne: have to do it every year. You have to do it every year, yeah. What do you mean do what? Every
Nathan: you have to laser harden your teeth. 'cause the acid does eventually get in between those hydroxyapatite molecule gaps. Eventually they get in. Eventually when you're chewing food, you wear your teeth. So because our, coating, it's not even a coating, it's into the enamel.
It's not on the outside of the enamel. We remove the carbon slightly inside the enamel. But it's, like I said, it's very thin. Another way of thinking about it is like a piece of Saran wrap. It's four times thinner than a piece of
Anne: wrap all over your teeth okay, so back up. know I'm a hygienist and I haven't practiced since 2020, so forgive me if these questions are kind of silly, but
my understanding is most people should have a. Appointment every six months. And so you're saying, it has to be done once a year, so that what you're talking about?
The appointment
is once a year or what?
Nathan: you should clean your teeth twice a year, so you should have your appointment every six months.
The hardening you don't need to do every year, although depends from person to person.
There's no harm in hardening. I. Every six months. So it just depends. Uh, People that salivate more, for instance their enamel lasts longer. People that salivate less so, just depends. The hygienist can advise you based on what she knows of your oral health but there's no harm in doing it.
What'll happen is if you have certain spots that were missed or certain spots that have worn that, it'll just harden them up again. And remove the carbonate from those areas, right? And then you just keep going. If there's no carbonate there, then it doesn't do anything because there's nothing to remove. it,
Anne: Wow. I'm,
so intrigued because I have never used the laser in the hygiene bay, so
Nathan: should, and it's so simple.
Anne: I know, and I, I know there's a lot of hygienists out there that are listening to this also that are very familiar with that technology, and I just never delved into it because of the practices I worked in, but I'm so intrigued by.
The advancements that you have made with your company, and I'm sure there's some others out there that are, trying, this is just like the future we were just talking about that this is like the future of dentistry to, to limit the time. what would the appointment schedule look like?
Like 45 minutes.
Nathan: we're hoping like a 45, 50 minute appointment would be 30 minutes. Right. And then the hygienists can do other things other than cleaning teeth all day long, four days a week. Right. the way the speed is achieved.
a fiber laser has a fiber, or they, sometimes there's a tip and that's a single beam of energy coming out, a single laser
beam coming up.
So what we do is we put moving mirrors inside the unit. So what comes out of our hand, piece is 75 individual beams. we have 75 beams. So with that one beam, you get out of the fiber or the we break that into 75 beams. So we end up with a pattern of 75 spots the size of a pencil eraser. And that's, that's, how you're able to clean the teeth quickly. That's the technology, that's one of our patents.
Anne: That is really interesting and very cool. And of course if the hygienist or, you know, we don't clean teeth, that's one of the things we're like, there's different terms for scalings and root plannings and things like that, but how has this technology been developed is it brand new, Nathan? yeah.
Nathan: yeah. It's brand new. So, um, the technology was developed at the University of California, San Francisco. Dr. Featherstone is, quite famous in the dental research community. Dr. Freed, Dr. Reman, I still talk to Dr. Freed frequently. Dr. Featherstone's retired. I think Dr. Reman retired last year as well. So the three of them pioneered the technology. Dr. Reed's still there continuing it. So
Their primary goal was to harden teeth, to preserve enamel, right?
Their research goals are how can we preserve enamel so when people get older, their teeth aren't as yellow, aren't as thin, aren't cracking. So that,
why they developed the technology. We're applying that technology to both
cleaning the teeth first and then hardening the teeth second, so they would use, small patterns.
And we came over the way to like a 75 point pattern so we could do it. More quickly, right? Because commercially, everybody loves the technology. How do you actually implement it
Anne: to the successful,
Nathan: you know, method? right?
Anne: because it's all, dollars in the pocket is time is really important and patient's comfort is important.
And everybody's busy. they want to haveteeth for a lifetime,
Nathan: And hygienist comfort is important too, Anne.
Anne: Hygienist comfort is really important. I think that would be really cool. I, I'm dying to like, get back in the clinical atmosphere and use one of these. what does
Nathan: it look like? it's a
machine? it's a machine on four wheels. You can put the machine behind you or side of the chair. There's a beam delivery much similar to Sole or Fontana. But we've changed that significantly to make it much more user-friendly. spent a six or nine months, again, just trying to make it very easy for the hygienist to use, to balance, to go about, about the mouth. Commonly with lasers you know, the hygienist or the, or the dentist is going to a fixed spot in the mouth. So we're going over every tooth, right? So we had to make the whole beam delivery of the laser much more. Ergonomic so that the hygienist could do it comfortably and quickly. So we spent a lot, a lot of time doing that. So we made it 60% smaller than sole. We made it 50% lighter than sole. And we're doing a couple things that are a little bit different. First of all, there's no screen on the unit where you select different pulse energies or rep rates or anything like that.
So. What's the learning curve So the learning curve is, there's three buttons. So you plug it in, you turn it on by pressing the green button. If you press the white button and the white light comes on. that means you're ready to go to clean.
Okay, if you press the blue button, the white lock button will go off and the blue button light will come on. And now you're ready
to harden. And then when you want the laser to be emitted, you press on the foot pedal. So the laser comes out, there's a green light that shows you where the laser will go. So you're not, blind. cause the
laser's invisible. So there's a green light just to show you where to go, and you just hold the.
The handpiece. A quarter inch, or six millimeters away from the tooth. And you just go back and forth from the top to the bottom you might see a little smoke, you might
smell 'cause you're, you're vaporizing the plaque,
right? A little bit of a smell. Sometimes, depending on how much tarter the patient has, they might hear like a little bit of a, noise in their head.
It's not much very, very low level. You can't hear anything in the room, if you will. But all those things just tell people that, something's happening. ' you don't feel anything anymore, right? No.
Anne: Wow. So you're not
using hand instruments and you're not using a
Nathan: No. that's right. But there are
Anne: are extreme cases,
Nathan: right? is not a magic tool.
Anne: it's one of your tools.
Nathan: right. 90,
Anne: 90, 95% of the conditions, you, won't need anything so
it sounds like you would start with that and clear the whole area and then go back and make sure that everything's exactly the way you want it with maybe an explorer
Nathan: Yeah. No, you don't actually have to do that. luckily, the laser when it denatures the plaque or the tartar, if it doesn't completely vaporize it, it leaves Where it is, is a little brown spot. It lifts it off the enamel, but it might not completely vaporize it. So you can go back in with like a polisher, a toothbrush and brush it off so
you know that you haven't missed anything. we should get a video of that. But it's very straightforward. You just see it, so you just brush it off then you're, you're all set. You've cleaned the teeth the enamel's clean.
It's dry. and the bacteria, the biggest thing really. you know, The bacteria is killed, the viruses are killed. Especially if you go up under the gums with a diamond tip. 'cause a lot of the gingivitis when you get older people
don't worry about gingivitis twenties and thirties. I mean Some, but mostly don't. Right? So if you could just keep that plaque build up under the gums and
Anne: the bacteria
Nathan: under the gums keep your gums healthy, right? So yeah, I think it's a wonderful Mary Jo Potter. I thank you very much. The university of california, san francisco. Right.
We thank them very much for 30 years of hard work and research. And hopefully this'll change the clinical side then, then, like I said, we take the camera and we take your 3D scan at the same time. And so with the scan
Anne: we can match it.
Nathan: map your cavities. You don't have to do that manually anymore.
Anne: So you can see it up on a
Nathan: yeah.
Anne: oh, that's very cool.
Nathan: We don't have our own screen you have to either connect wifi or, you can plug in a wire. our device we don't have any extra screens or anything. That imaging goes to the practice management system inside the dental office. So then all your records are kept together.
Anne: That's cool.
Nathan: this thing in dentistry I don't mean to be critical or anything, but full of one,
I call 'em one, trick ponies where, okay, I gotta do this, I gotta go get that, I gotta do this, I gotta go get that a lot is not integrated, right? So
we've emphasized the integration, right? So once we get that imaging done. We get it onto your practice management system where you can integrate it into the patient record, and then also whoever's running the practice management software, can go to the cloud, have it AI processed just like they do with x-rays at the moment.
But the AI wouldn't be for finding cavities like X-rays. The AI would be finding cracked teeth or night grinding or an overbite. It would tell you, we'll give you a scale of one to 10, how fast your enamel is eroding. So if you're a high odor, you can do something about it. Maybe harden your teeth two or three, four times a year.
Right? We will tell you if your gums are receding greater than normal, right? So you can. Clean under your gums more thoroughly, and you can track it with the ai. So if you start in your twenties and your thirties and you track it for two or three years, you can create a regimen where you keep your enamel, where you keep your gums, And I think once people can see it on the screen, they can see the tracking
going on, like getting your lipid panel, tracking your cholesterol level or your triglycerides. So then you can track it and then people will, pay extra money for the visits if they need to, but they just don't know right now.
So it's a matter of giving them the knowledge and then it's
Anne: it's important for people to see it.
Nathan: to trust it.
Anne: yes, And that's all the, new imaging, that's the, reason for it and the beauty of it. And then you said integration. So it's interesting because all the different softwares now, they started out like a one trick pony. But now what you hear
Nathan: what dentistry future
Anne: dentistry is integrating all of the technology outside of the patient. This
Nathan: is integrating everything inside
Anne: the patient.
Nathan: That's right. And also patients, if they see it on their, on the practice management system with the complete software it's much more believable. If we had like a little screen on our unit, you turned it sideways and you looked at the screen, I.
There's some people would believe it's something, but if you stand up and you look at the practice management software and they say, look, this is what's going on, right? And then every time they come in for a cleaning, couple times a year you just get another scan. So you take a kid, for instance, who's eight years old and they're getting their teeth cleaned, but by the time they're ready for braces, five. 6, 7, 8 years later, you've got 10, 15
scans. So then you can see how the teeth came in, where the teeth went as they came in. You can take all 10 or 15 scans. You can take the best bits of each one, not me, but the software guys can take the best bits of each one and create a.
master scan, a more perfect scan. So The beauty of it, like I said at the beginning is you get a scan every cleaning and it doesn't take
any extra time, and over time
Anne: you'll build up that record,
Nathan: That oral health record and it tells a story. Yeah.
Anne: and that's really important a good bang for your buck when you're making your appointment and your dentist is feeling confident that the work is being done well, and the patient is like, this is pretty cool and it didn't hurt, and I'm outta here in 30 minutes versus, you know, an hour and dreading it.
you know, this is very interesting. I love the fact that three dentists came together They're sages I would think they know a little bit about dentistry and then they saw a need and they found some way to, fulfill the success of just having
a healthy, clean mouth from the first twos to the last,
Nathan: Yeah. Yeah. So UCSF's College of Dentistry, you know, well-known, Dr. Featherstone is, well-rounded at the FDA, all of the, fluoride developments front and center.
And then once that was all established, then they went off to try to find something better, to do something better with the teeth. And we're really just leveraging that work. And making it practical, right? Making it so that, you can have a device that's reasonably priced that goes fast enough.
And then with the ai you see your first AI. Health report. You don't have to really do anything.
If you've got a crack tooth, of course you have to do something, but your teeth and your gums, they don't disappear
in 12 months or 24 months. So you can wait and they can see an appointment after appointment and they can see a building out and what's going on.
I think that'll be very comforting to people and they'll trust it and they'll see that, You know, There's science
Anne: technology
Nathan: and, I think they'll pay to keep their teeth I had been, in my twenties, I'd get my teeth laser hardened every, every
Anne: Every year.
Nathan: every year every, every six months.
Right. I mean, It's just,
Anne: makes sense.
Yeah, it's really new technology. happy to share it. I, this is going to cause a lot of conversation in the dental field, kind of a, disruptor, if you will, and ahead of the curve.
So thank you so much. How do we, like, how do we get in touch? You guys have a website? What's, how do we get in touch with you
Nathan: enamelpure.com,
Anne: enamelpure.com.
Nathan: Yep. And just,
Anne: contact
us Okay. Just click it.
Nathan: Yep.
Anne: more Do you have white papers and things like
that on your
Nathan: No, we don't link to the white papers. We're trying to be an every man company a, company
that, not really a research company, but more of a practical every man company.
So it's, more geared towards you know, health. We use for our whitening, we use ultra pure. you know, Hydrogen peroxide, everything we do, we do with, you know, the idea of purity in mind. Pure enamel pure substances. So we try to, not be a research company, but a
Anne: practical, high purity
Nathan: company.
Anne: young people out there especially are looking for that kind of thing,
Nathan: Yeah, the progressive side of dentistry. There's the traditional side of dentistry where it's not quite as important, but the progressive side of dentistry, is vital and the progressive side is growing and growing,
Anne: Yeah. Yes. And you're in the forefront of it. So thank you so much, Nathan Monty, for being with me today. I learned a lot. I'm so excited to learn more it is a game changer for the clinician, the patient, and the future. So thank you so much for being with me today. I look forward to it.
And for everybody that's listening today, thanks for joining us and the most important thing that you can do out there is to remember to keep doing you.
Thanks so much and
have a great day. I'll see you next
time. Thanks. Bye-Bye.
